| Kendallville Family Care Center Inc | |
|
130 Lake Terrace Dr Kendallville IN 46755-1819 | |
| (260) 349-9240 | |
| (260) 349-9244 |
| Full Name | Kendallville Family Care Center Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 130 Lake Terrace Dr, Kendallville, Indiana |
| Authorized Official Name and Position | Rex A Flenar (OWNER) |
| Authorized Official Contact | 2603499240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kendallville Family Care Center Inc 130 Lake Terrace Dr Kendallville IN 46755-1819 Ph: (260) 349-9240 | Kendallville Family Care Center Inc 130 Lake Terrace Dr Kendallville IN 46755-1819 Ph: (260) 349-9240 |
| NPI Number | 1396060307 |
|---|---|
| Provider Enumeration Date | 04/01/2010 |
| Last Update Date | 10/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396060307 | NPI | - | NPPES |
| 201009760A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01036102 (Indiana) | Primary |
Directclinic Sbc, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 W Ohio St, Kendallville, IN 46755 Phone: 260-212-1906 | |
Brooklyn Medical Associates, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 326 Sawyer Rd, Kendallville, IN 46755 Phone: 260-747-6171 Fax: 260-478-5125 |